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Adverse Renal Effects of Novel Molecular Oncologic Targeted Therapies: A Narrative Review

Kenar D Jhaveri1, Rimda Wanchoo1, Vipulbhai Sakhiya1

  • 1Department of Internal Medicine, Division of Kidney Diseases and Hypertension, Hofstra Northwell School of Medicine, Northwell Health, Great Neck, New York, USA.

Kidney International Reports
|January 11, 2018
PubMed

Insights

Targeted cancer therapies improve survival but can cause kidney damage. Electrolyte disorders, renal impairment, and hypertension are common adverse renal events, requiring early diagnosis by nephrologists.

Area of Science:

  • Oncology
  • Nephrology
  • Pharmacology

Background:

  • Targeted anti-cancer therapies offer improved patient survival over traditional chemotherapy.
  • Increasing recognition of renal toxicities associated with targeted cancer agents.
  • Nephrotoxicity patterns vary based on the specific drug target.

Purpose of the Study:

  • To review adverse renal effects of approved targeted cancer therapies.
  • To identify common nephrotoxic events and specific agents with high reported events.
  • To emphasize the importance of early diagnosis and recognition of renal toxicities.

Main Methods:

  • Review of adverse renal effects associated with targeted therapies.
  • Focus on agents targeting EGFR, HER2, BRAF, MEK, ALK, PD1/PDL1, CTLA-4, VEGF/R, and TKIs.
  • Analysis of reported nephrotoxic events, including ipilimumab and cetuximab.

Main Results:

  • Electrolyte disorders, renal impairment, and hypertension are the most frequent renal adverse events.
  • Ipilimumab and cetuximab are associated with a higher incidence of nephrotoxic events among novel agents.
  • Variability in incidence, severity, and pattern of renal toxicities exists across different drug targets.

Conclusions:

  • Early diagnosis and prompt recognition of renal adverse events are crucial for patient management.
  • Nephrologists play a vital role in managing patients receiving targeted cancer therapies.
  • Understanding the spectrum of renal toxicities is essential for safe and effective use of these novel agents.
Keywords:
AKIchemotherapyhypokalemiahyponatremianephrotoxicityonconephrologyrenal failuretargeted therapy

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